POS1512-HPR FATIGUE AND MOOD DISORDERS AS DETERMINANTS OF QUALITY OF LIFE IN PATIENTS WITH RA TREATED WITH BIOLOGICS
Authors: W. Tański, N. Świątoniowska-Lonc, B. Jankowska-Polańska
Journal: Annals of the Rheumatic Diseases (2022)

Background Rheumatoid arthritis (RA) includes many conditions that affect joints, the tissues surrounding the joints, and other connective tissues. 1 In 2012, the prevalence of RA in the USA was estimated to be 22.7% (52.5 million adults over 18 years of age) and projected to increase to 49% (about 78 million Americans) by 2040. 2 The disease causes pain and limits physical function. 3 It is accompanied by fatigue, anxiety and even depression, which may not be considered important by those around the patient, but may be crucial for the patient. 4 Research on the impact of psychosocial factors on the quality of life (QoL) of patients receiving biologic therapy is still limited. There is a need to identify new psychological determinants affecting the course of treatment of patients with RA and their quality of life and perception of health. Objectives The aim of the study was to assess the level of QoL and the association of selected psychosocial (depression, anxiety, fatigue) and clinical (pain) factors with the quality of life of patients with RA treated with biologics. Methods Standardized questionnaires were used in the study to assess the level of anxiety and depression (Hospital Anxiety and Depression Scale), quality of life (WHOQoL-BREF), pain (Visual Analogue Scale) and fatigue (Modified Fatigue Impact Scale). Results A total of 63 RA patients (61.9% women) aged 52.38±16.97 years treated with biologics were enrolled in the study. Mean disease duration in the study group was 13.54±9.51 years. The level of fatigue in MFIS questionnaire was 25.96±16.14, the level of depression and anxiety assessed by HADS, respectively was (17.1±2.2 vs (20.0±2.3)). In QoL assessment, the highest scores were obtained in psychological (16.5±1.86) and environmental (14.47±- 2.22) domains, and the lowest in physical domain (11.4±-2.41). In regression analysis, pain negatively affected the psychological domain (5.11±2.55) and social life of 6.03% of patients. Patients assessed their QoL as average and almost half of the respondents (42.86%) were dissatisfied with their health. In correlation analysis, anxiety (r=-0.472, p&lt;0.001), depression (r=-0.322, p=0.01) and mental fatigue (r=-0.271, p=0.047) significantly decreased patients’ QoL in psychological domain. In multivariate analysis, depression (R=-0.126,p=0.002) was a significant independent determinant of QoL perception, disease duration (R=-0.104, p=0.001) was a significant determinant of QoL in the psychological domain, and obesity (R=-2.427, p=0.013) and depression (R=-0.244, p=0.008) were significant in the physical QoL domain. Conclusion The quality of life of RA patients treated with biologics is moderate. The independent determinants of QoL are obesity, depression and disease duration. There is a need to introduce diagnostics recognizing mood disorders in order to implement individual remedial projects aimed at prevention and re-education of depression and improvement of QoL. References [1]Gibofsky A. Overview of epidemiology, pathophysiology, and diagnosis of rheumatoid arthritis. Am J Manag Care. 2012. Dec 18; 13(Suppl):S295–302. [2]Alonso J, Ferrer M, Gandek B, et al. Health-related quality of life associated with chronic conditions in eight countries: results from the international quality of life assessment (IQOLA) project. Qual Life Res. 2004;13:283–298. [3]Vlak T. Utjecaj reumatoidnog artritisa na radnu sposobnost bolesnika. Reumatizam. 2001;48(1):12–8. [4]Dickens C, McGowan L, Clark-Carter D, Creed F. Depression in rheumatoid arthritis: a systematic review of the literature with meta-analysis. Psychosom Med. 2002 Jan-Feb;64(1):52-60. doi: 10.1097/00006842-200201000-00008. PMID: 11818586. Disclosure of Interests None declared